Long-term quality of life after endoscopic removal of sinonasal inverted papillomas: a 6-year cohort analysis in a tertiary academic hospital

Inverted papillomas may affect the (para)nasal cavity. While some of these papillomas can undergo malignant transformation, others grow slowly and cause few if any symptoms. An endoscopic approach is seen as providing a balance between the greatest removal possible and avoiding unnecessary morbidity. However, the actual long-term quality of life of patients having undergone surgery for inverted papillomas has never been studied. Our primary aim is to assess the long-term sequelae and the quality of life of patients after endoscopic surgery of sinonasal inverted papillomas. The secondary aim is to establish which nasal symptoms, if any, are the most prevalent before and after surgery. We used the SNOT-22 questionnaire to assess the quality of life of patients who had undergone endoscopic surgery for sinonasal inverted papillomas between 2000 and 2011. Twenty-seven out of 34 patients returned the questionnaire (79 % response rate). Median follow-up was 6 years (range 1-10). Mean age was 58.9 years (range 40-85). Median SNOT-22 score was 12, while the most frequent postoperative symptom was the need to blow the nose (18 patients) and the most frequent preoperative symptom was nasal obstruction. Patients after endoscopic removal of sinonasal inverted papillomas return to an almost normal quality of life, as measured by the disease-specific questionnaire SNOT-22. The most frequent symptom was the need to blow the nos

Zoonotic bacterial meningitis in human adults

To describe the epidemiology, etiology, clinical characteristics, treatment, outcome, and prevention of zoonotic bacterial meningitis in human adults. We identified 16 zoonotic bacteria causing meningitis in adults. Zoonotic bacterial meningitis is uncommon compared to bacterial meningitis caused by human pathogens, and the incidence has a strong regional distribution. Zoonotic bacterial meningitis is mainly associated with animal contact, consumption of animal products, and an immunocompromised state of the patient. In a high proportion of zoonotic bacterial meningitis cases, CSF analysis showed only a mildly elevated leukocyte count. The recommended antibiotic therapy differs per pathogen, and the overall mortality is low. Zoonotic bacterial meningitis is uncommon but is associated with specific complications. The suspicion should be raised in patients with bacterial meningitis who have recreational or professional contact with animals and in patients living in regions endemic for specific zoonotic pathogens. An immunocompromised state is associated with a worse prognosis. Identification of risk factors and underlying disease is necessary to improve treatmen

Negative Myoclonus Induced by Ciprofloxacin

Background:&nbsp;Negative myoclonus is characterized by a brief sudden loss of muscle activity, and can be caused by a variety of acquired factors and epilepsy syndromes.Phenomenology Shown:&nbsp;We show a clear video example of a patient with an extensive negative myoclonus that was induced by ciprofloxacin.Educational Value:&nbsp;Several neurotoxic effects have been associated with the use of ciprofloxacin, but negative myoclonus has not been reported previously.&nbsp;</p

<i>Streptococcus suis</i> Meningitis: A Systematic Review and Meta-analysis

<div><p>Background</p><p><i>Streptococcus suis</i> is the most common cause of meningitis in pork consuming and pig rearing countries in South-East Asia. We performed a systematic review of studies on <i>S</i>. <i>suis</i> meningitis to define the clinical characteristics, predisposing factors and outcome.</p><p>Methodology</p><p>Studies published between January 1, 1980 and August 1, 2015 were identified from main literature databases and reference lists. Studies were included if they were written in West-European languages and described at least 5 adult patients with <i>S</i>. <i>suis</i> meningitis in whom at least one clinical characteristic was described.</p><p>Findings</p><p>We identified 913 patients with <i>S</i>. <i>suis</i> meningitis included in 24 studies between 1980 and 2015. The mean age was 49 years and 581 of 711 patients were male (82%). Exposure to pigs or pork was present in 395 of 648 patients (61%) while other predisposing factors were less common. 514 of 528 patients presented with fever (97%), 429 of 451 with headache (95%), 462 of 496 with neck stiffness (93%) and 78 of 384 patients (20%) had a skin injury in the presence of pig/pork contact. The case fatality rate was 2.9% and hearing loss was a common sequel occurring in 259 of 489 patients (53%). Treatment included dexamethasone in 157 of 300 (52%) of patients and was associated with reduced hearing loss in <i>S</i>. <i>suis</i> meningitis patients included in a randomized controlled trial.</p><p>Conclusion</p><p><i>S</i>. <i>suis</i> meningitis has a clear association with pig and pork contact. Mortality is low, but hearing loss occurs frequently. Dexamethasone was shown to reduce hearing loss.</p></div

Clinical characteristics of patients with <i>S</i>. <i>suis</i> meningitis.

<p>N* number of patients in whom the symptom was reported</p><p>¹Triad of fever, neck stiffness and altered consciousness</p><p>^aMeans are recalculated from means and medians</p><p>^bReported in 715 cases</p><p>^cReported in 322 cases</p><p>^dReported in 213 cases</p><p>^eReported in 395 cases</p><p>^fReported in 380 cases</p><p>^gReported in 177 cases</p><p>Clinical characteristics of patients with <i>S</i>. <i>suis</i> meningitis.</p

Flow-chart systematic review <i>Streptococcus suis</i> meningitis.

<p>Flow-chart systematic review <i>Streptococcus suis</i> meningitis.</p